Addressing Disparities in
Uterine Fibroid Embolization
October 15, 2025
Education
2021 - B.S., Biology, University of Kentucky
2026 - M.D., Indiana University School of Medicine
Work History
2023-2025 Research Assistant (Department of Medical and Molecular Genetics)
2020-2022 Research Assistant (Spinal Cord and Brain Injury Research Center)
42-year-old woman
Hypertension, dyslipidemia, diabetes
Heavy menstrual bleeding, pelvic pressure, fatigue
What’s your differential?
What’s your differential?
Enlarged uterus (~14 weeks size)
Diagnosis?
What kind?
Type 0: pedunculated intracavitary
Type 1: <50% intramural
Type 2: ≥50% intramural
Type 3: 100% intramural; contacts endometrium
Type 4: intramural
Type 5: subserosal ≥50% intramural
Type 6: subserosal <50% intramural
Type 7: subserosal pedunculated
Type 8: other, e.g. cervical, parasitic
What next?
Medical Management
First-line for most patients
Options: NSAIDs, tranexamic acid, combined oral contraceptives, progestins, LnG-IUD
Guideline: ACOG recommends starting with medical therapy for symptomatic management
Reproductive plans and timing
Symptom severity and impact on quality of life
Treatment risks and recovery expectations
Long-term outcomes and recurrence risks
Personal values and preferences
ACOG Practice Bulletin #228 (2021)
ACR Appropriateness Criteria®
SIR Guidelines for UAE
ESHRE Guidelines on Fibroid Management